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3. Neutrophil-to-Lymphocyte Ratio and Outcomes in Patients Admitted for Acute Heart Failure (As Seen in the BLAST-AHF, Pre-RELAX-AHF, and RELAX-AHF Studies)

Author

Davison, Beth A., Takagi, Koji, Edwards, Christopher, Adams, Kirkwood F., Jr, Butler, Javed, Collins, Sean P., Dorobantu, Maria I., Ezekowitz, Justin A., Filippatos, Gerasimos, Greenberg, Barry H., Levy, Phillip D., Masip, Josep, Metra, Marco, Pang, Peter S., Ponikowski, Piotr, Severin, Thomas M., Teerlink, John R., Teichman, Sam L., Voors, Adriaan A., Werdan, Karl, and Cotter, Gad

Published
2022
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5. Características epidemiológicas, clínicas y evolutivas de los pacientes con insuficiencia cardiaca aguda y shock cardiogénico diagnosticados en urgencias.

Author

Espinosa, Begoña, Llorens, Pere, Jacob, Javier, Gil, Víctor, Alquézar, Aitor, Ballarín, Elena Dieste, López-Díez, María Pilar, Garrido, José Manuel, del Amo, Sonia, Tost, Josep, Arias, Pilar Paz, Llauger, Lluís, Herrero-Puente, Pablo, Gorlicki, Judith, Masip, Josep, and Miró, Òscar

Published
2024
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8. Early intravenous nitroglycerin use in prehospital setting and in the emergency department to treat patients with acute heart failure: Insights from the EAHFE Spanish registry

Author

Miró, Òscar, Llorens, Pere, Freund, Yonathan, Davison, Beth, Takagi, Koji, Herrero-Puente, Pablo, Jacob, Javier, Martín-Sánchez, Francisco Javier, Gil, Víctor, Rosselló, Xavier, Alquézar-Arbé, Aitor, Jiménez-Fábrega, Francesc X., Masip, Josep, Mebazaa, Alexandre, and Cotter, Gad

Published
2021
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9. Organ dysfunction, injury and failure in acute heart failure: from pathophysiology to diagnosis and management. A review on behalf of the Acute Heart Failure Committee of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC).

Author

Harjola, Veli-Pekka, Mullens, Wilfried, Banaszewski, Marek, Bauersachs, Johann, Brunner-La Rocca, Hans-Peter, Chioncel, Ovidiu, Collins, Sean, Doehner, Wolfram, Filippatos, Gerasimos, Flammer, Andreas, Fuhrmann, Valentin, Lainscak, Mitja, Lassus, Johan, Legrand, Matthieu, Masip, Josep, Mueller, Christian, Papp, Zoltán, Parissis, John, Platz, Elke, Rudiger, Alain, Ruschitzka, Frank, Schäfer, Andreas, Seferovic, Petar, Skouri, Hadi, Yilmaz, Mehmet, and Mebazaa, Alexandre

Subjects
Heart failure, Multiple organ failure, Venous congestion, Acute Disease, Cardiology, Diagnostic Imaging, Disease Management, Europe, Heart Failure, Humans, Multiple Organ Failure, Societies, Medical
Abstract

Organ injury and impairment are commonly observed in patients with acute heart failure (AHF), and congestion is an essential pathophysiological mechanism of impaired organ function. Congestion is the predominant clinical profile in most patients with AHF; a smaller proportion presents with peripheral hypoperfusion or cardiogenic shock. Hypoperfusion further deteriorates organ function. The injury and dysfunction of target organs (i.e. heart, lungs, kidneys, liver, intestine, brain) in the setting of AHF are associated with increased risk for mortality. Improvement in organ function after decongestive therapies has been associated with a lower risk for post-discharge mortality. Thus, the prevention and correction of organ dysfunction represent a therapeutic target of interest in AHF and should be evaluated in clinical trials. Treatment strategies that specifically prevent, reduce or reverse organ dysfunction remain to be identified and evaluated to determine if such interventions impact mortality, morbidity and patient-centred outcomes. This paper reflects current understanding among experts of the presentation and management of organ impairment in AHF and suggests priorities for future research to advance the field.

Published
2017

10. Effect of early initiation of noninvasive ventilation in patients transported by emergency medical service for acute heart failure.

Author

Gorlicki, Judith, Masip, Josep, Gild, Víctor, Llorens, Pere, Jacob, Javier, Alquézar-Arbé, Aitor, Baldrich, Eva Domingo, Fortuny, María José, Romero, Marta, Esquivias, Marco Antonio, García, Rocío Moyano, García, Yelenis Gómez, Noceda, José, Rodríguezo, Pablo, Aguirre, Alfons, López-Díez, M. Pilar, Mir, María, Serrano, Leticia, de Frutos, Marta Fuentes, and Curtelín, David

Published
2024
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12. A pragmatic approach to the use of inotropes for the management of acute and advanced heart failure: An expert panel consensus

Author

Farmakis, Dimitrios, Agostoni, Piergiuseppe, Baholli, Loant, Bautin, Andrei, Comin-Colet, Josep, Crespo-Leiro, Maria G., Fedele, Francesco, García-Pinilla, Jose Manuel, Giannakoulas, George, Grigioni, Francesco, Gruchała, Marcin, Gustafsson, Finn, Harjola, Veli-Pekka, Hasin, Tal, Herpain, Antoine, Iliodromitis, Efstathios K., Karason, Kristjan, Kivikko, Matti, Liaudet, Lucas, Ljubas-Maček, Jana, Marini, Marco, Masip, Josep, Mebazaa, Alexandre, Nikolaou, Maria, Ostadal, Petr, Põder, Pentti, Pollesello, Piero, Polyzogopoulou, Eftihia, Pölzl, Gerhard, Tschope, Carsten, Varpula, Marjut, von Lewinski, Dirk, Vrtovec, Bojan, Yilmaz, Mehmet Birhan, Zima, Endre, and Parissis, John

Published
2019
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15. Diagnosis and treatment of right ventricular failure secondary to acutely increased right ventricular afterload (acute cor pulmonale). A Clinical Consensus Statement of the Association for Acute CardioVascular Care (ACVC) of the ESC

Author

Arrigo, Mattia, primary, Price, Susanna, additional, Harjola, Veli-Pekka, additional, Huber, Lars C, additional, Schaubroeck, Hannah A I, additional, Vieillard-Baron, Antoine, additional, Masip, Josep, additional, and Mebazaa, Alexandre, additional

Published
2023
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17. Effects on short term outcome of non-invasive ventilation use in the emergency department to treat patients with acute heart failure: A propensity score-based analysis of the EAHFE Registry

Author

Fuentes, Marta, Gil, Cristina, Alonso, Héctor, Garmila, Pablo, Adrada, Esther Rodríguez, Escoda, Rosa, Xipell, Carolina, Sánchez, Carolina, Gaytan, Josep Mª., Salvo, Eva, Pérez-Durá, María José, Noval, Antonio, Torres, José M., Gómez, Maria Ángeles Juan, López-Grima, María Luisa, Valero, Amparo, Aguirre, Alfons, Pedragosa, Maria Àngels, Alonso, Maria Isabel, Ruiz, Francisco, Franco, José Miguel, Diaz, Elena, Mecina, Ana Belén, Tost, Josep, Sánchez, Susana, Piñera, Pascual, Garate, Raquel Torres, Alquezar, Aitor, Rizzi, Miguel Alberto, Herrera, Sergio, Cabello, Irene, Pérez, José María Álvarez, Diez, Maria Pilar López, Alvarez, Joaquin Vázquez, Gonzalez, Marta Sánchez, Román, Jose Juan Gil, Carratalá, José Manuel, Brouzet, Benjamin, Marquina, Víctor, Jiménez, Inmaculada, Hernández, Néstor, Román, Francisco, Andueza, Juan Antonio, Romero, Rodolfo, Calvache, Roberto, Lorca, Maria Teresa, Calderón, Luis, Arriaga, Beatriz Amores, Sierra, Beatriz, Mojarro, Enrique Martín, Bécquer, Lisette Travería, Garcia, Lluís Llauger, LaSalle, Gerard Corominas, Urbano, Carmen Agüera, Ferrer, Ester Soy, Miró, Òscar, Martínez, Gemma, Masip, Josep, Gil, Víctor, Martín-Sánchez, Francisco Javier, Llorens, Pere, Herrero-Puente, Pablo, Richard, Fernando, Lucas-Invernón, Javier, Garrido, José Manuel, Mebazaa, Alexandre, Ríos, José, Peacock, W. Frank, Hollander, Judd E., and Jacob, Javier

Published
2018
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18. Levosimendan Efficacy and Safety: 20 years of SIMDAX in Clinical Use

Author

Papp, Zoltán, Agostoni, Piergiuseppe, Alvarez, Julian, Bettex, Dominique, Bouchez, Stefan, Brito, Dulce, Cˇerný, Vladimir, Comin-Colet, Josep, Crespo-Leiro, Marisa G, Delgado, Juan F, Édes, Istvan, Eremenko, Alexander A, Farmakis, Dimitrios, Fedele, Francesco, Fonseca, Cândida, Fruhwald, Sonja, Girardis, Massimo, Guarracino, Fabio, Harjola, Veli-Pekka, Heringlake, Matthias, Herpain, Antoine, Heunks, Leo MA, Husebye, Tryggve, Ivancan, Višnja, Karason, Kristjan, Kaul, Sundeep, Kivikko, Matti, Kubica, Janek, Masip, Josep, Matskeplishvili, Simon, Mebazaa, Alexandre, Nieminen, Markku S, Oliva, Fabrizio, Papp, Julius-Gyula, Parissis, John, Parkhomenko, Alexander, Põder, Pentti, Pölzl, Gerhard, Reinecke, Alexander, Ricksten, Sven-Erik, Riha, Hynek, Rudiger, Alain, Sarapohja, Toni, Schwinger, Robert HG, Toller, Wolfgang, Tritapepe, Luigi, Tschöpe, Carsten, Wikström, Gerhard, von Lewinski, Dirk, Vrtovec, Bojan, and Pollesello, Piero

Published
2020
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21. Repetitive use of levosimendan in advanced heart failure: need for stronger evidence in a field in dire need of a useful therapy

Author

Pölzl, Gerhard, Altenberger, Johann, Baholli, Loant, Beltrán, Paola, Borbély, Attila, Comin-Colet, Josep, Delgado, Juan F., Fedele, Francesco, Fontana, Antonella, Fruhwald, Friedrich, Giamouzis, Gregory, Giannakoulas, George, Garcia-González, Martín J., Gustafsson, Finn, Kaikkonen, Kari, Kivikko, Matti, Kubica, Jacek, von Lewinski, Dirk, Löfman, Ida, Malfatto, Gabriella, Manito, Nicolás, Martínez-Sellés, Martin, Masip, Josep, Merkely, Bela, Morandi, Fabrizio, Mølgaard, Henning, Oliva, Fabrizio, Pantev, Emil, Papp, Zoltán, Perna, Gian Piero, Pfister, Roman, Piazza, Vito, Bover, Ramón, Rangel-Sousa, Diego, Recio-Mayoral, Alejandro, Reinecke, Alexander, Rieth, Andreas, Sarapohja, Toni, Schmidt, Gunter, Seidel, Mirko, Störk, Stefan, Vrtovec, Bojan, Wikström, Gerhard, Yerly, Patrik, and Pollesello, Piero

Published
2017
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24. Acute heart failure and valvular heart disease: A scientific statement of the Heart Failure Association, the Association for Acute CardioVascular Care and the European Association of Percutaneous Cardiovascular Interventions of the European Society of Cardiology

Author

Chioncel, Ovidiu, primary, Adamo, Marianna, additional, Nikolaou, Maria, additional, Parissis, John, additional, Mebazaa, Alexandre, additional, Yilmaz, Mehmet Birhan, additional, Hassager, Christian, additional, Moura, Brenda, additional, Bauersachs, Johann, additional, Harjola, Veli‐Pekka, additional, Antohi, Elena‐Laura, additional, Ben‐Gal, Tuvia, additional, Collins, Sean P., additional, Iliescu, Vlad Anton, additional, Abdelhamid, Magdy, additional, Čelutkienė, Jelena, additional, Adamopoulos, Stamatis, additional, Lund, Lars H., additional, Cicoira, Mariantonietta, additional, Masip, Josep, additional, Skouri, Hadi, additional, Gustafsson, Finn, additional, Rakisheva, Amina, additional, Ahrens, Ingo, additional, Mortara, Andrea, additional, Janowska, Ewa A., additional, Almaghraby, Abdallah, additional, Damman, Kevin, additional, Miro, Oscar, additional, Huber, Kurt, additional, Ristic, Arsen, additional, Hill, Loreena, additional, Mullens, Wilfried, additional, Chieffo, Alaide, additional, Bartunek, Jozef, additional, Paolisso, Pasquale, additional, Bayes‐Genis, Antoni, additional, Anker, Stefan D., additional, Price, Susanna, additional, Filippatos, Gerasimos, additional, Ruschitzka, Frank, additional, Seferovic, Petar, additional, Vidal‐Perez, Rafael, additional, Vahanian, Alec, additional, Metra, Marco, additional, McDonagh, Theresa A., additional, Barbato, Emanuele, additional, Coats, Andrew J.S., additional, and Rosano, Giuseppe M.C., additional

Published
2023
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25. Levosimendan beyond inotropy and acute heart failure: Evidence of pleiotropic effects on the heart and other organs: An expert panel position paper

Author

Farmakis, Dimitrios, Alvarez, Julian, Gal, Tuvia Ben, Brito, Dulce, Fedele, Francesco, Fonseca, Candida, Gordon, Anthony C., Gotsman, Israel, Grossini, Elena, Guarracino, Fabio, Harjola, Veli-Pekka, Hellman, Yaron, Heunks, Leo, Ivancan, Visnja, Karavidas, Apostolos, Kivikko, Matti, Lomivorotov, Vladimir, Longrois, Dan, Masip, Josep, Metra, Marco, Morelli, Andrea, Nikolaou, Maria, Papp, Zoltán, Parkhomenko, Alexander, Poelzl, Gerhard, Pollesello, Piero, Ravn, Hanne Berg, Rex, Steffen, Riha, Hynek, Ricksten, Sven-Erik, Schwinger, Robert H.G., Vrtovec, Bojan, Yilmaz, M. Birhan, Zielinska, Marzenna, and Parissis, John

Published
2016
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28. The role of levosimendan in acute heart failure complicating acute coronary syndrome: A review and expert consensus opinion

Author

Nieminen, Markku S., Buerke, Michael, Cohen-Solál, Alain, Costa, Susana, Édes, István, Erlikh, Alexey, Franco, Fatima, Gibson, Charles, Gorjup, Vojka, Guarracino, Fabio, Gustafsson, Finn, Harjola, Veli-Pekka, Husebye, Trygve, Karason, Kristjan, Katsytadze, Igor, Kaul, Sundeep, Kivikko, Matti, Marenzi, Giancarlo, Masip, Josep, Matskeplishvili, Simon, Mebazaa, Alexandre, Møller, Jacob E., Nessler, Jadwiga, Nessler, Bohdan, Ntalianis, Argyrios, Oliva, Fabrizio, Pichler-Cetin, Emel, Põder, Pentti, Recio-Mayoral, Alejandro, Rex, Steffen, Rokyta, Richard, Strasser, Ruth H., Zima, Endre, and Pollesello, Piero

Published
2016
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30. Repetitive levosimendan infusions for patients with advanced chronic heart failure in the vulnerable post-discharge period : The multinational randomized LeoDOR trial

Author

Poelzl, Gerhard, Altenberger, Johann, Comin-Colet, Josep, Delgado, Juan F., Fedele, Francesco, Garcia-Gonzalez, Martin Jesus, Gustafsson, Finn, Masip, Josep, Papp, Zoltan, Stoerk, Stefan, Ulmer, Hanno, Maier, Sarah, Vrtovec, Bojan, Wikström, Gerhard, Zima, Endre, Bauer, Axel, Poelzl, Gerhard, Altenberger, Johann, Comin-Colet, Josep, Delgado, Juan F., Fedele, Francesco, Garcia-Gonzalez, Martin Jesus, Gustafsson, Finn, Masip, Josep, Papp, Zoltan, Stoerk, Stefan, Ulmer, Hanno, Maier, Sarah, Vrtovec, Bojan, Wikström, Gerhard, Zima, Endre, and Bauer, Axel

Abstract

Aim The LeoDOR trial explored the efficacy and safety of intermittent levosimendan therapy in the vulnerable phase following a hospitalization for acute heart failure (HF) Methods and results In this prospective multicentre, double-blind, two-armed trial, patients with advanced HF were randomized 2:1 at the end of an index hospitalization for acute HF to intermittent levosimendan therapy or matching placebo for 12weeks. All patients had left ventricular ejection fraction (LVEF) =30% during index hospitalization. Levosimendan was administered according to centre preference either as 6 h infusion at a rate of 0.2 mu g/kg/min every 2weeks, or as 24 h infusion at a rate of 0.1 mu g/kg/min every 3weeks. The primary efficacy assessment after 14weeks was based on a global rank score consisting of three hierarchical groups. Secondary clinical endpoints included the composite risk of tiers 1 and 2 at 14 and 26weeks, respectively. Due to the COVID-19 pandemic, the planned number of patients could not be recruited. The final modified intention-to-treat analysis included 145 patients (93 in the combined levosimendan arm, 52 in the placebo arm), which reduced the statistical power to detect a 20% risk reduction in the primary endpoint to 60%. Compared with placebo, intermittent levosimendan had no significant effect on the primary endpoint: the mean rank score was 72.55 for the levosimendan group versus 73.81 for the placebo group (p= 0.863). However, there was a signal towards a higher incidence of the individual clinical components of the primary endpoint in the levosimendan group versus the placebo group both after 14weeks (hazard ratio [HR] 2.94, 95% confidence interval [CI] 1.12- 7.68; p= 0.021) and 26weeks (HR 1.64, 95% CI 0.87- 3.11; p= 0.122). Among patients recently hospitalized with HF and reduced LVEF, intermittent levosimendan therapy did not improve post-hospitalization clinical stability. [GRAPHICS.]

Published
2023
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31. Acute heart failure and valvular heart disease:A scientific statement of the Heart Failure Association, the Association for Acute CardioVascular Care and the European Association of Percutaneous Cardiovascular Interventions of the European Society of Cardiology

Author

Chioncel, Ovidiu, Adamo, Marianna, Nikolaou, Maria, Parissis, John, Mebazaa, Alexandre, Yilmaz, Mehmet Birhan, Hassager, Christian, Moura, Brenda, Bauersachs, Johann, Harjola, Veli Pekka, Antohi, Elena Laura, Ben-Gal, Tuvia, Collins, Sean P., Iliescu, Vlad Anton, Abdelhamid, Magdy, Čelutkienė, Jelena, Adamopoulos, Stamatis, Lund, Lars H., Cicoira, Mariantonietta, Masip, Josep, Skouri, Hadi, Gustafsson, Finn, Rakisheva, Amina, Ahrens, Ingo, Mortara, Andrea, Janowska, Ewa A., Almaghraby, Abdallah, Damman, Kevin, Miro, Oscar, Huber, Kurt, Ristic, Arsen, Hill, Loreena, Mullens, Wilfried, Chieffo, Alaide, Bartunek, Jozef, Paolisso, Pasquale, Bayes-Genis, Antoni, Anker, Stefan D., Price, Susanna, Filippatos, Gerasimos, Ruschitzka, Frank, Seferovic, Petar, Vidal-Perez, Rafael, Vahanian, Alec, Metra, Marco, McDonagh, Theresa A., Barbato, Emanuele, Coats, Andrew J.S., Rosano, Giuseppe M.C., Chioncel, Ovidiu, Adamo, Marianna, Nikolaou, Maria, Parissis, John, Mebazaa, Alexandre, Yilmaz, Mehmet Birhan, Hassager, Christian, Moura, Brenda, Bauersachs, Johann, Harjola, Veli Pekka, Antohi, Elena Laura, Ben-Gal, Tuvia, Collins, Sean P., Iliescu, Vlad Anton, Abdelhamid, Magdy, Čelutkienė, Jelena, Adamopoulos, Stamatis, Lund, Lars H., Cicoira, Mariantonietta, Masip, Josep, Skouri, Hadi, Gustafsson, Finn, Rakisheva, Amina, Ahrens, Ingo, Mortara, Andrea, Janowska, Ewa A., Almaghraby, Abdallah, Damman, Kevin, Miro, Oscar, Huber, Kurt, Ristic, Arsen, Hill, Loreena, Mullens, Wilfried, Chieffo, Alaide, Bartunek, Jozef, Paolisso, Pasquale, Bayes-Genis, Antoni, Anker, Stefan D., Price, Susanna, Filippatos, Gerasimos, Ruschitzka, Frank, Seferovic, Petar, Vidal-Perez, Rafael, Vahanian, Alec, Metra, Marco, McDonagh, Theresa A., Barbato, Emanuele, Coats, Andrew J.S., and Rosano, Giuseppe M.C.

Abstract

Acute heart failure (AHF) represents a broad spectrum of disease states, resulting from the interaction between an acute precipitant and a patient's underlying cardiac substrate and comorbidities. Valvular heart disease (VHD) is frequently associated with AHF. AHF may result from several precipitants that add an acute haemodynamic stress superimposed on a chronic valvular lesion or may occur as a consequence of a new significant valvular lesion. Regardless of the mechanism, clinical presentation may vary from acute decompensated heart failure to cardiogenic shock. Assessing the severity of VHD as well as the correlation between VHD severity and symptoms may be difficult in patients with AHF because of the rapid variation in loading conditions, concomitant destabilization of the associated comorbidities and the presence of combined valvular lesions. Evidence-based interventions targeting VHD in settings of AHF have yet to be identified, as patients with severe VHD are often excluded from randomized trials in AHF, so results from these trials do not generalize to those with VHD. Furthermore, there are not rigorously conducted randomized controlled trials in the setting of VHD and AHF, most of the data coming from observational studies. Thus, distinct to chronic settings, current guidelines are very elusive when patients with severe VHD present with AHF, and a clear-cut strategy could not be yet defined. Given the paucity of evidence in this subset of AHF patients, the aim of this scientific statement is to describe the epidemiology, pathophysiology, and overall treatment approach for patients with VHD who present with AHF., Acute heart failure (AHF) represents a broad spectrum of disease states, resulting from the interaction between an acute precipitant and a patient's underlying cardiac substrate and comorbidities. Valvular heart disease (VHD) is frequently associated with AHF. AHF may result from several precipitants that add an acute haemodynamic stress superimposed on a chronic valvular lesion or may occur as a consequence of a new significant valvular lesion. Regardless of the mechanism, clinical presentation may vary from acute decompensated heart failure to cardiogenic shock. Assessing the severity of VHD as well as the correlation between VHD severity and symptoms may be difficult in patients with AHF because of the rapid variation in loading conditions, concomitant destabilization of the associated comorbidities and the presence of combined valvular lesions. Evidence-based interventions targeting VHD in settings of AHF have yet to be identified, as patients with severe VHD are often excluded from randomized trials in AHF, so results from these trials do not generalize to those with VHD. Furthermore, there are not rigorously conducted randomized controlled trials in the setting of VHD and AHF, most of the data coming from observational studies. Thus, distinct to chronic settings, current guidelines are very elusive when patients with severe VHD present with AHF, and a clear-cut strategy could not be yet defined. Given the paucity of evidence in this subset of AHF patients, the aim of this scientific statement is to describe the epidemiology, pathophysiology, and overall treatment approach for patients with VHD who present with AHF.

Published
2023

32. Acute heart failure and valvular heart disease: A scientific statement of the Heart Failure Association, the Association for Acute CardioVascular Care and the European Association of Percutaneous Cardiovascular Interventions of the European Society of Cardiology

Author

Chioncel, Ovidiu, Adamo, Marianna, Nikolaou, Maria, Parissis, John, Mebazaa, Alexandre, Yilmaz, Mehmet Birhan, Hassager, Christian, Moura, Brenda, Bauersachs, Johann, Harjola, Veli-Pekka, Antohi, Elena-Laura, Ben-Gal, Tuvia, Collins, Sean P, Iliescu, Vlad Anton, Abdelhamid, Magdy, Čelutkienė, Jelena, Adamopoulos, Stamatis, Lund, Lars H, Cicoira, Mariantonietta, Masip, Josep, Skouri, Hadi, Gustafsson, Finn, Rakisheva, Amina, Ahrens, Ingo, Mortara, Andrea, Janowska, Ewa A, Almaghraby, Abdallah, Damman, Kevin, Miro, Oscar, Huber, Kurt, Ristic, Arsen, Hill, Loreena, Mullens, Wilfried, Chieffo, Alaide, Bartunek, Jozef, Paolisso, Pasquale, Bayes-Genis, Antoni, Anker, Stefan D, Price, Susanna, Filippatos, Gerasimos, Ruschitzka, Frank, Seferovic, Petar, Vidal-Perez, Rafael, Vahanian, Alec, Metra, Marco, Mcdonagh, Theresa A, Barbato, Emanuele, Coats, Andrew J S, and Rosano, Giuseppe M C

Subjects
Acute heart failure, Management, Valvular heart disease
Abstract

Acute heart failure (AHF) represents a broad spectrum of disease states, resulting from the interaction between an acute precipitant and a patient's underlying cardiac substrate and comorbidities. Valvular heart disease (VHD) is frequently associated with AHF. AHF may result from several precipitants that add an acute haemodynamic stress superimposed on a chronic valvular lesion or may occur as a consequence of a new significant valvular lesion. Regardless of the mechanism, clinical presentation may vary from acute decompensated heart failure to cardiogenic shock. Assessing the severity of VHD as well as the correlation between VHD severity and symptoms may be difficult in patients with AHF because of the rapid variation in loading conditions, concomitant destabilization of the associated comorbidities and the presence of combined valvular lesions. Evidence-based interventions targeting VHD in settings of AHF have yet to be identified, as patients with severe VHD are often excluded from randomized trials in AHF, so results from these trials do not generalize to those with VHD. Furthermore, there are not rigorously conducted randomized controlled trials in the setting of VHD and AHF, most of the data coming from observational studies. Thus, distinct to chronic settings, current guidelines are very elusive when patients with severe VHD present with AHF, and a clear-cut strategy could not be yet defined. Given the paucity of evidence in this subset of AHF patients, the aim of this scientific statement is to describe the epidemiology, pathophysiology, and overall treatment approach for patients with VHD who present with AHF.

Published
2023

37. Repetitive levosimendan infusions for patients with advanced chronic heart failure in the vulnerable post‐discharge period: The multinational randomized LeoDOR trial.

Author

Pölzl, Gerhard, Altenberger, Johann, Comín‐Colet, Josep, Delgado, Juan F., Fedele, Francesco, García‐González, Martín Jesús, Gustafsson, Finn, Masip, Josep, Papp, Zoltán, Störk, Stefan, Ulmer, Hanno, Maier, Sarah, Vrtovec, Bojan, Wikström, Gerhard, Zima, Endre, Bauer, Axel, Michael Zaruba, Marc, Dörler, Jakob, von Lewinski, Dirk, and Fruhwald, Friedrich

Subjects
HEART failure, LEVOSIMENDAN, BRAIN natriuretic factor, VENTRICULAR ejection fraction
Abstract

Aim: The LeoDOR trial explored the efficacy and safety of intermittent levosimendan therapy in the vulnerable phase following a hospitalization for acute heart failure (HF). Methods and results: In this prospective multicentre, double‐blind, two‐armed trial, patients with advanced HF were randomized 2:1 at the end of an index hospitalization for acute HF to intermittent levosimendan therapy or matching placebo for 12 weeks. All patients had left ventricular ejection fraction (LVEF) ≤30% during index hospitalization. Levosimendan was administered according to centre preference either as 6 h infusion at a rate of 0.2 μg/kg/min every 2 weeks, or as 24 h infusion at a rate of 0.1 μg/kg/min every 3 weeks. The primary efficacy assessment after 14 weeks was based on a global rank score consisting of three hierarchical groups. Secondary clinical endpoints included the composite risk of tiers 1 and 2 at 14 and 26 weeks, respectively. Due to the COVID‐19 pandemic, the planned number of patients could not be recruited. The final modified intention‐to‐treat analysis included 145 patients (93 in the combined levosimendan arm, 52 in the placebo arm), which reduced the statistical power to detect a 20% risk reduction in the primary endpoint to 60%. Compared with placebo, intermittent levosimendan had no significant effect on the primary endpoint: the mean rank score was 72.55 for the levosimendan group versus 73.81 for the placebo group (p = 0.863). However, there was a signal towards a higher incidence of the individual clinical components of the primary endpoint in the levosimendan group versus the placebo group both after 14 weeks (hazard ratio [HR] 2.94, 95% confidence interval [CI] 1.12–7.68; p = 0.021) and 26 weeks (HR 1.64, 95% CI 0.87–3.11; p = 0.122). Conclusions: Among patients recently hospitalized with HF and reduced LVEF, intermittent levosimendan therapy did not improve post‐hospitalization clinical stability. [ABSTRACT FROM AUTHOR]

Published
2023
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38. Heart failure during the COVID-19 pandemic: clinical, diagnostic, management, and organizational dilemmas

Author

Palazzuoli, Alberto, Metra, Marco, Collins, Sean P., Adamo, Marianna, Ambrosy, Andrew P., Antohi, Laura E., Ben Gal, Tuvia, Farmakis, Dimitrios, Gustafsson, Finn, Hill, Loreena, Lopatin, Yuri, Tramonte, Francesco, Lyon, Alexander, Masip, Josep, Miro, Oscar, Moura, Brenda, MULLENS, Wilfried, Radu, Razvan, I, Abdelhamid, Magdy, Anker, Stefan, Chioncel, Ovidiu, Gustafsson, Finn/0000-0003-2144-341X, Palazzuoli, Alberto, Metra, Marco, Collins, Sean P., Adamo, Marianna, Ambrosy, Andrew P., Antohi, Laura E., Ben Gal, Tuvia, Farmakis, Dimitrios, Gustafsson, Finn, Hill, Loreena, Lopatin, Yuri, Tramonte, Francesco, Lyon, Alexander, Masip, Josep, Miro, Oscar, Moura, Brenda, MULLENS, Wilfried, Radu, Razvan, I, Abdelhamid, Magdy, Anker, Stefan, and Chioncel, Ovidiu

Subjects
Diagnostic differentiation, COVID-19, Heart failure, Management
Abstract

The coronavirus 2019 (COVID-19) infection pandemic has affected the care of patients with heart failure (HF). Several consensus documents describe the appropriate diagnostic algorithm and treatment approach for patients with HF and associated COVID-19 infection. However, few questions about the mechanisms by which COVID can exacerbate HF in patients with high-risk (Stage B) or symptomatic HF (Stage C) remain unanswered. Therefore, the type of HF occurring during infection is poorly investigated. The diagnostic differentiation and management should be focused on the identification of the HF phenotype, underlying causes, and subsequent tailored therapy. In this framework, the relationship existing between COVID and onset of acute decompensated HF, isolated right HF, and cardiogenic shock is questioned, and the specific management is mainly based on local hospital organization rather than a standardized model. Similarly, some specific populations such as advanced HF, heart transplant, patients with left ventricular assist device (LVAD), or valve disease remain under investigated. In this systematic review, we examine recent advances regarding the relationships between HF and COVID-19 pandemic with respect to epidemiology, pathogenetic mechanisms, and differential diagnosis. Also, according to the recent HF guidelines definition, we highlight different clinical profile identification, pointing out the main concerns in understudied HF populations.

Published
2022

39. Heart failure during the COVID‐19 pandemic: clinical, diagnostic, management, and organizational dilemmas

Author

Palazzuoli, Alberto, primary, Metra, Marco, additional, Collins, Sean P., additional, Adamo, Marianna, additional, Ambrosy, Andrew P., additional, Antohi, Laura E., additional, Ben Gal, Tuvia, additional, Farmakis, Dimitrios, additional, Gustafsson, Finn, additional, Hill, Loreena, additional, Lopatin, Yuri, additional, Tramonte, Francesco, additional, Lyon, Alexander, additional, Masip, Josep, additional, Miro, Oscar, additional, Moura, Brenda, additional, Mullens, Wilfried, additional, Radu, Razvan I., additional, Abdelhamid, Magdy, additional, Anker, Stefan, additional, and Chioncel, Ovidiu, additional

Published
2022
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40. Serelaxin, recombinant human relaxin-2, for treatment of acute heart failure (RELAX-AHF): a randomised, placebo-controlled trial

Author

Teerlink, John R, Cotter, Gad, Davison, Beth A, Felker, G Michael, Filippatos, Gerasimos, Greenberg, Barry H, Ponikowski, Piotr, Unemori, Elaine, Voors, Adriaan A, Adams, Kirkwood F, Jr, Dorobantu, Maria I, Grinfeld, Liliana R, Jondeau, Guillaume, Marmor, Alon, Masip, Josep, Pang, Peter S, Werdan, Karl, Teichman, Sam L, Trapani, Angelo, Bush, Christopher A, Saini, Rajnish, Schumacher, Christoph, Severin, Thomas M, and Metra, Marco

Published
2013
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41. Soluble urokinase-type plasminogen activator receptor improves early risk stratification in cardiogenic shock

Author

Hongisto, Mari, Lassus, Johan, Tarvasmäki, Tuukka, Sans-Roselló, Jordi, Tolppanen, Heli, Kataja, Anu, Jäntti, Toni, Sabell, Tuija, Banaszewski, Marek, Silva-Cardoso, Jose, Parissis, John, Jurkko, Raija, Spinar, Jindrich, Castrén, Maaret, Mebazaa, Alexandre, Masip, Josep, Harjola, Veli-Pekka, Universitat Autònoma de Barcelona, HUS Emergency Medicine and Services, Department of Diagnostics and Therapeutics, University of Helsinki, HUS Heart and Lung Center, Department of Medicine, Kardiologian yksikkö, and Clinicum

Subjects
Supar, MYOCARDIAL-INFARCTION, PREDICTION, MORTALITY, Biomarker, General Medicine, 3126 Surgery, anesthesiology, intensive care, radiology, Cardiology and Cardiovascular Medicine, Critical Care and Intensive Care Medicine, Cardiogenic shock, Risk stratification, suPAR
Abstract

Aims Soluble urokinase–type plasminogen activator receptor (suPAR) is a biomarker reflecting the level of immune activation. It has been shown to have prognostic value in acute coronary syndrome and heart failure as well as in critical illness. Considering the complex pathophysiology of cardiogenic shock (CS), we hypothesized suPAR might have prognostic properties in CS as well. The aim of this study was to assess the kinetics and prognostic utility of suPAR in CS. Methods and results SuPAR levels were determined in serial plasma samples (0–96 h) from 161 CS patients in the prospective, observational, multicentre CardShock study. Kinetics of suPAR, its association with 90-day mortality, and additional value in risk-stratification were investigated. The median suPAR-level at baseline was 4.4 [interquartile range (IQR) 3.2–6.6)] ng/mL. SuPAR levels above median were associated with underlying comorbidities, biomarkers reflecting renal and cardiac dysfunction, and higher 90-day mortality (49% vs. 31%; P = 0.02). Serial measurements showed that survivors had significantly lower suPAR levels at all time points compared with nonsurvivors. For risk stratification, suPAR at 12 h (suPAR12h) with a cut-off of 4.4 ng/mL was strongly associated with mortality independently of established risk factors in CS: OR 5.6 (95% CI 2.0–15.5); P = 0.001) for death by 90 days. Adding suPAR12h > 4.4 ng/mL to the CardShock risk score improved discrimination identifying high-risk patients originally categorized in the intermediate-risk category. Conclusion SuPAR associates with mortality and improves risk stratification independently of other previously known risk factors in CS patients.

Published
2022
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45. Heart failure during the COVID-19 pandemic:clinical, diagnostic, management, and organizational dilemmas

Author

Palazzuoli, Alberto, Metra, Marco, Collins, Sean P., Adamo, Marianna, Ambrosy, Andrew P., Antohi, Laura E., Ben Gal, Tuvia, Farmakis, Dimitrios, Gustafsson, Finn, Hill, Loreena, Lopatin, Yuri, Tramonte, Francesco, Lyon, Alexander, Masip, Josep, Miro, Oscar, Moura, Brenda, Mullens, Wilfried, Radu, Razvan I., Abdelhamid, Magdy, Anker, Stefan, Chioncel, Ovidiu, Palazzuoli, Alberto, Metra, Marco, Collins, Sean P., Adamo, Marianna, Ambrosy, Andrew P., Antohi, Laura E., Ben Gal, Tuvia, Farmakis, Dimitrios, Gustafsson, Finn, Hill, Loreena, Lopatin, Yuri, Tramonte, Francesco, Lyon, Alexander, Masip, Josep, Miro, Oscar, Moura, Brenda, Mullens, Wilfried, Radu, Razvan I., Abdelhamid, Magdy, Anker, Stefan, and Chioncel, Ovidiu

Abstract

The coronavirus 2019 (COVID-19) infection pandemic has affected the care of patients with heart failure (HF). Several consensus documents describe the appropriate diagnostic algorithm and treatment approach for patients with HF and associated COVID-19 infection. However, few questions about the mechanisms by which COVID can exacerbate HF in patients with high-risk (Stage B) or symptomatic HF (Stage C) remain unanswered. Therefore, the type of HF occurring during infection is poorly investigated. The diagnostic differentiation and management should be focused on the identification of the HF phenotype, underlying causes, and subsequent tailored therapy. In this framework, the relationship existing between COVID and onset of acute decompensated HF, isolated right HF, and cardiogenic shock is questioned, and the specific management is mainly based on local hospital organization rather than a standardized model. Similarly, some specific populations such as advanced HF, heart transplant, patients with left ventricular assist device (LVAD), or valve disease remain under investigated. In this systematic review, we examine recent advances regarding the relationships between HF and COVID-19 pandemic with respect to epidemiology, pathogenetic mechanisms, and differential diagnosis. Also, according to the recent HF guidelines definition, we highlight different clinical profile identification, pointing out the main concerns in understudied HF populations.

Published
2022

47. Contemporary management of acute right ventricular failure: a statement from the Heart Failure Association and the Working Group on Pulmonary Circulation and Right Ventricular Function of the European Society of Cardiology

Author

Harjola, Veli-Pekka, Mebazaa, Alexandre, Čelutkienė, Jelena, Bettex, Dominique, Bueno, Hector, Chioncel, Ovidiu, Crespo-Leiro, Maria G., Falk, Volkmar, Filippatos, Gerasimos, Gibbs, Simon, Leite-Moreira, Adelino, Lassus, Johan, Masip, Josep, Mueller, Christian, Mullens, Wilfried, Naeije, Robert, Nordegraaf, Anton Vonk, Parissis, John, Riley, Jillian P., Ristic, Arsen, Rosano, Giuseppe, Rudiger, Alain, Ruschitzka, Frank, Seferovic, Petar, Sztrymf, Benjamin, Vieillard-Baron, Antoine, Yilmaz, Mehmet Birhan, and Konstantinides, Stavros

Published
2016
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48. Impact of congestion and perfusion status in the emergency department on severity of decompensation and short-term prognosis in patients with acute heart failure.

Author

Espinosa, Begoña, Llorens, Pere, Gil, Víctor, Jacob, Javier, Alquézar-Arbé, Aitor, Masip, Josep, Llauger, Lluís, Tost, Josep, Andueza, Juan Antonio, Garrido, José Manuel, Soy-Ferrer, Ester, Agüera-Urbano, Carmen, Herrero, Pablo, Gil-Rodrigo, Adriana, Millán, Javier, Mecina, Ana Belén, Torres-Gárate, Raquel, Cabrera-González, Nayra, Núñez, Julio, and Miró, Òscar

Published
2023
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49. Recommendations on pre-hospital and early hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine – short version

Author

Mebazaa, Alexandre, Yilmaz, M. Birhan, Levy, Phillip, Ponikowski, Piotr, Peacock, W. Frank, Laribi, Said, Ristic, Arsen D., Lambrinou, Ekaterini, Masip, Josep, Riley, Jillian P., McDonagh, Theresa, Mueller, Christian, deFilippi, Christopher, Harjola, Veli-Pekka, Thiele, Holger, Piepoli, Massimo F., Metra, Marco, Maggioni, Aldo, McMurray, John J.V., Dickstein, Kenneth, Damman, Kevin, Seferovic, Petar M., Ruschitzka, Frank, Leite-Moreira, Adelino F., Bellou, Abdelouahab, Anker, Stefan D., and Filippatos, Gerasimos

Published
2015
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50. Evaluation of the effect of intravenous nitroglycerine on short-term survival of patients with acute heart failure according to congestion and perfusion status at emergency department arrival.

Author

Miró, Òscar, Espinosa, Begoña, Gil, Víctor, Jacob, Javier, Alquézar-Arbé, Aitor, Masip, Josep, Llauger, Lluís, Tost, Josep, Andueza, Juan Antonio, Garrido, José Manuel, Mojarro, Enrique Martín, Urbano, Carmen Agüera, Núñez, Julio, Chioncel, Ovidiu, Mullens, Wilfred, Cotter, Gad, and Llorens, Pere

Published
2022
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